Patient Outcomes No Better For Joint Commission–Accredited Hospitals Than Peers

The study finds no association between hospital accreditation and lower mortality, and only slightly better outcomes for 30-day readmissions for 15 common conditions.

Hospitals that earn certification by independent accreditors, such as The Joint Commission, have no better outcomes than hospitals reviewed by a state survey agency, according to a new report in the BMJ.

"Furthermore, we found that accreditation by The Joint Commission, which is the most common form of hospital accreditation, was not associated with better patient outcomes than other lesser known, independent accrediting agencies," the study concluded.

Researchers at Harvard T.H. Chan School of Public Health compared 4,400 hospitals across the United States, of which 3,337 were accredited, including 2,847 by The Joint Commission, and 1,063 hospitals that underwent state-based reviews between 2014 and 2017.

The study reviewed more than 4.2 million Medicare inpatient records for people ages 65 and older who were admitted for 15 common medical and six common surgical conditions, and respondents to the Hospital Consumer Assessment of Healthcare Provider and Systems survey.

"Hospital accreditation by independent organizations is not associated with lower mortality, and is only slightly associated with reduced readmission rates for the 15 common medical conditions selected in this study," the study said.

Among the findings:

• Thirty-day readmissions for The Joint Commission-accredited hospitals were 0.4% lower than those at hospitals that were reviewed by state survey agencies, which the researchers called "not statistically significant lower rates."
   
• Mortality rates for the six surgical conditions were "nearly identical," and "no statistically significant differences were seen in 30-day mortality or readmission rates (for both the medical or surgical conditions) between The Joint Commission-accredited hospitals, and hospitals rated by other independent accreditors.
   
• Readmissions for the 15 medical conditions "were significantly lower at accredited hospitals than at state survey hospitals (22.4% v 23.2%, 0.8% (0.4% to 1.3%), but did not differ for the surgical conditions (15.9% v 15.6%, 0.3% (−1.2% to 1.6%), the study found.
   
• Patient experience scores were modestly better at state survey hospitals than at accredited hospitals. Among accredited hospitals, The Joint Commission did not have significantly different patient experience scores compared to other independent organizations.

While not the only hospital accrediting entity in the United States, the study authors note that private, not-for-profit The Joint Commission plays an outsized role, and controls more than 80% of the accreditation market as the accrediting agency of choice for nearly all major hospital systems.

"There was no evidence in this study to indicate that patients choosing a hospital accredited by The Joint Commission confer any healthcare benefits over choosing a hospital accredited by another independent accrediting organization," the study concluded.

The Joint Commission could not immediately be reached Friday morning for comment.